• Aki Shinzato, Ken Tabuchi, Yoshiko Atsuta, Masami Inoue, Jiro Inagaki, Hiromasa Yabe, Katsuyoshi Koh, Koji Kato, Hideaki Ohta, Hisato Kigasawa, Toshiyuki Kitoh, Atsushi Ogawa, Yoshiyuki Takahashi, Yoji Sasahara, Shun-Ichi Kato, and Souichi Adachi.
• Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
• Pediatr Blood Cancer. 2013 Sep 1; 60 (9): 1513-9.

BackgroundPeripheral blood stem cells (PBSC) may be used as an alternative to bone marrow (BM) for allogeneic transplantation. Since peripheral blood stem cell bank from unrelated volunteer donor has been started in Japan, use of PBSC allografts may be increased. Therefore we surveyed the outcomes of Japanese leukemia children after PBSC and BM transplantation.ProcedureThis retrospective study compared the outcomes of 661 children (0-18 years) with acute lymphoblastic leukaemia (ALL) or acute myeloid leukaemia (AML) who received their first allogeneic peripheral blood stem cell transplantation (PBSCT; n = 90) or bone marrow transplantation (BMT; n = 571) from HLA-matched siblings between January 1996 and December 2007.ResultNeutrophil recovery was faster after PBSCT than after BMT (ALL: P < 0.0001; AML: P = 0.0002), as was platelet recovery (ALL: P = 0.0008; AML: P = 0.0848). However, the cumulative incidence of chronic graft-versus-host disease (GvHD) was higher after PBSCT than after BMT (ALL: 26.0% vs. 9.9%, P = 0.0066; AML: 41.6% vs. 11.1%, P < 0.0001). The 5-year disease-free survival (DFS) was lower after PBSCT than after BMT for ALL (40.6% vs. 57.1%, P = 0.0257). The 5-year overall survival (OS) was lower after PBSCT than after BMT for ALL (42.4% vs. 63.7%, P = 0.0032) and AML (49.8% vs. 71.8%, P = 0.0163). Multivariate analysis revealed the use of PBSC was a significant risk factor for DFS and OS. PBSCT and BMT did not differ in relapse rate, acute GvHD for ALL and AML, or in DFS for AML.ConclusionPBSC allografts in Japanese children engraft faster but are associated with poorer survival and increased chronic GvHD.Copyright © 2013 Wiley Periodicals, Inc.

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